Parental substance abuse is a risk factor for child maltreatment, neglect and multi-generational drug abuse. Developing efficacious, cost-efficient interventions is critical to addressing this growing problem. This article by Brian Porter, Luz Porter, Virginia McCoy, Mayra Lima, Clare Pryce and Sachin Nunnewar highlights lessons learned during the first year of a study based in Florida to evaluate a novel parenting intervention targeting substance-abusing mothers and their babies.